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Misidentification subtype of Alzheimer's disease psychosis predicts a faster cognitive decline

D'Antonio, F; Reeves, S; Sheng, Y; McLachlan, E; de Lena, C; Howard, R; Bertrand, J; (2019) Misidentification subtype of Alzheimer's disease psychosis predicts a faster cognitive decline. CPT Pharmacometrics and Systems Pharmacology 10.1002/psp4.12389. (In press). Green open access

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Abstract

The presence of psychosis is associated with more rapid decline in Alzheimer's disease (AD), but the impact of paranoid (persecutory delusions) and misidentification (misperceptions and/or hallucinations) subtypes of psychosis on the speed of decline in AD is still unclear. Here we analysed data on Alzheimer's Disease Neuroimaging Initiative (ADNI)2 participants with late mild cognitive impairment or AD and we described individual trajectories of Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-cog) scores using a semi-mechanistic, logistic model, with a mixed effects based approach, which accounted for drop-out, and adjusted for baseline Mini Mental State Examination scores. The covariate model included psychosis subtypes, age, gender, education, medications and Apo-e ε4 genotype. We found that ADAS-cog rate of increase was doubled in misidentification (βr,misid_subtype =0.63, p=0.031) and mixed (both subtypes) ((βr,mixed_subtype =0.70, p=0.003) compared to non-psychotic (or paranoid) subjects suggesting that the misidentification subtype may represent a distinct AD sub-phenotype associated with an accelerated pathological process. This article is protected by copyright. All rights reserved.

Type: Article
Title: Misidentification subtype of Alzheimer's disease psychosis predicts a faster cognitive decline
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/psp4.12389
Publisher version: https://doi.org/10.1002/psp4.12389
Language: English
Additional information: This is an open access article under the terms of the Creative Commons Attribution‐NoDerivs License (http://creativecommons.org/licenses/by-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited and no modifications or adaptations are made.
Keywords: Alzheimer's disease, misidentification, nonlinear mixed effect modelling, psychosis, subtypes
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > Div of Biosciences
URI: https://discovery.ucl.ac.uk/id/eprint/10068982
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